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.NAU COIfNTRY INSURANCE COMPANY <br />7333 SUNWOOD DRIVE NW <br />RAMSEY, MN 55303 -5119 <br />(763)427 -3770 <br />j lac`' Z <br />Dp q Do�d <br />— E3NAU COUNTRY. <br />- Statement # 76966757 <br />(II Premium Statement 11/01/2012 Account# 46067861 <br />Page 1 of 3 <br />r <= <br />�f u <br />56201 AB 0.374 <br />.............AUTO "ALL FOR AADC 680 025 <br />PLATTE RIVER RECOVERY IMPLEMENTA <br />FOUNDATION <br />PO BOX 83107 sa^� <br />LINCOLN NE 68501 -3107 <br />Account Balance $ 632.42 <br />Current Due $ 632.42 <br />Amount due If postmark after 11130/12 $640.13* <br />Detailed policy information Is provided on <br />the reverse side. The "Current Due" shown <br />Is what Is owed at this time. <br />Insurance Premium Fees Interest* Other Total Current Loss <br />Charges** Charges Payments Credit Balance <br />MPCI 587.00 30.00 15.42 632.42 - 632,42 L <br />HAILIFIRE - - -. _ —_ -- <br />NAMED PERIL <br />LIVESTOCK <br />Subsidy Provided by FCIC <br />MPCI A &O Subsidy SM Livestock A &O Subsidy ;o <br />MPCI Risk Subsidy $844 Livestock AiskSubsidy $0 <br />MPCI Gross Premium $1,431 Livestock Gross Premium $0 <br />The Account Balance and Current Due include any applicable subsidies. <br />The A &O amount may increase by 1.15 percent of net book premium (except for <br />group plans of insurance) if the loss ratio in the state exceeds 1.20. However, the <br />amount of premium the producer must pay will not be changed. <br />*Monthly interest charges of 1.25% per month (15% APR) will be charged on unpaid fees and premium balances not paid <br />within 30 days following the billing date on the amounts listed above, regardless if the account has a pending claim. For <br />crops with an 08 -15 -2012 Billing Date interest will begin attaching on 11 -01 -2012 and will be calculated from 09 -01 -2012. <br />**Other charges includes overpaid losses, premium taxes if applicable and miscellaneous account fees; such as NSF charges. <br />Thank you for doing business with NAU Country Insurance Company <br />Return bottom portion with your check made payable lb-._ NAU COUNTRY INSURANCE - COMPANY <br />or make your payment online by vfsii mg httpJJtuwtni�naucountry cam It`s safe.and _stmplet <br />Statement Date 11/0112012 <br />Current Due $632.42 <br />Amount Enclosed $.. _... . <br />Amount due if postmark after 11/30112 8640.13* <br />Please Romit Payment To: <br />NAU COUNTRY INSURANCE COMPANY <br />PO BOX 860057 <br />MINNEAPOLIS, MN 55486 -0057 <br />lid" 1` il�litli�l' iit'l lllii�li�iliilir�ritrr (r�r�ir,illlrt�l,(il <br />%Pelv,\NAU C OUNTRY. <br />Statement # 76966757 <br />Ac*ount # 46067861 <br />PLATTE RIVER RECOVERY <br />IMPLEMENTATION FOUNDATION <br />PO BOX 83107 <br />LINCOLN, NE 68501 <br />00769667S72 00460678610 0000063242 1 <br />